Demonstration of comfort and use of comfort devices

1. Comfort Devices

DEFINITION

Comfort is a state of freedom from pain, discomfort, tension & anxiety.

Comfort is define as “the contented enjoyment in physical or mental well-being, freedom from
pain or trouble & anxiety.”

DEFINITION OF DISCOMFART

Discomfort is define as want of comfort or ease due to client or annoyance.

The alert nurse quickly sense when the client is uncomfortable, sometimes before he is aware of
it himself. The skilful nurse knows may simple ways of easing discomfort & does not Think of a
sedation first.

CAUSES OF DISCOMFORT

 Pain
 Restriction of movements due to weakness Wrinkled,
 soiled & wet bed sheets Improper arrangement of pillows
 Delayed or inadequate attention to meet the personal need such as cleanliness,
 elimination,
 nourishment etc.
 Lack of exercise
 Extreme temperature
 Inadequate ventilation
 Indigestion
 irregular bowel movements
 Uncomfortable position
 Too bright light & glares
 Lack of sleep
 Noise Fear & anxiety
 Insecurity feelings
 Interruption of daily routines
NURSING NEEDS AND DISCOMFORT
Identification of the nursing problrm
Meeting the emergencies
Daily care

IDENTIFICATION OF THE NURSING PROBLRM

Even through two persons suffer from same type of problem/disease, the nursing problems in the
two persons will be different.

Some of the nursing problems are:-

Problems related to respiratory difficulty

Problems related to body temperature

Problems related to consciousness

Problems related to cardiac function

Problems related to appetite & digestion

Problems related to activity

Problems related to elimination

Problems related to mental activity

Other Problems

MEETING THE EMERGENCIES

Any nursing problem which demands immediate attention must be dealt with immediately.

Follow ABC

The problem of hemorrhage, shock & pain may become worse if immediate attention is not given

DAILY CARE

Certain procedure are carried out routinely in order to make the client comfortable. Such as
Morning Care

Evening Care

Night Care

COMFORT DEVICES PRAMOTING PHYSICAL COMFORT

Mechanical service or comfort devices are invented articles which would add to comfort of patient
when used in appropriate manner.

These devices relive the discomfort & help in maintaining correct posture.

COMFORT DEVICES PRAMOTING PHYSICAL COMFORT LIST

Pillows

Back Rest

Knee Rest

Rolls

Foot Rests/Foot Boards

Sand Bags

Air & Water Mattress

Rings

Bed Cradle

Bed Blocks
Air Cushion

PILLOWS

Pillows are used to give comfortable position to the patient.

THIS are mostly used to support various body part.

Purposes:-

 To maintain proper body alignment.

 To support body parts in good alignment.
 Help to reduce pressure.
 It can be folded, rolled or tucked firmly against the body to maintain position.
 It is used to support head, neck, arms, legs & parts of the back.

BACK REST

It is a mechanical device which provide a suitable support & rest for the back of patient in sitting
position.

Purposes:-

To support back.

To facilitate breathing.

It is given especially for heart & asthma patient even in post operative period.

KNEE REST

It may be substituted by a pillow

It gives relaxation & thus relieves pain on abdominal muscles & on tendons beneath the knees.

Many doctors do not allow knee pillows because of the fear of thrombus formation & pulmonary
embolism.

Change of position at frequent intervals is necessary.

ROLLS.

Hand rolls are made of cloth that rolled into a cylinder about 4-5 inches long & 2-3 inches in
diameter & stiffed firmly.

Purposes:-

To keep the fingers free being in a tight fist.

Thigh rolls are made by folding a sheet to the desired length of 2-3 feet & then rolled into a tight
cylinder. Thigh rolls are used to support hips & thighs, preventing them from outward rotation & kee

ping the feet in alignment in case of paralysis, fracture of femur & hip surgery.
FOOT REST

These are mechanical device used to give rest to feet. Sand bags or Foot board may be used.
Purposes:-

To maintain the normal position of feet.

To promote comfort.

To prevent foot drop.

SAND BAGS

These are canvas rubber or plastic bags filled with sand. These are used to immobilize a part.
Purposes:-

To relive discomfort.

Used to support body part.

Used to immobilize the body part.

Used to support a in fracture bones.

To prevent foot drop or wrist drop.

AIR & WATER MATTRESSES

These are used for very thin & obese patients & those who are prone to get pressure sores. It helps
in equal distribution of the pressure exerted on the body.

Purposes:-

To improve circulation.

To provide comfort.

To prevent pressure sore.

Used in very thin or obese patients & chronic bed ridden patients.

RINGS

Air rings are made of rubber.

The air rings is inflated about half full,

Tested for leakage, covered & than placed under the patient’s hips in such a way that the valve is on
one side & not in contact with body.

Cotton are made wrapped with bandage. These are placed under bony prominences such as heels &
fastened in place if necessary.

Purposes:-

To lift the hip from bed to prevent bed sores.

To prevent direct pressure on bony prominences.

To improve circulation
BED CRADLE

These very widely in size & in material.

These are of wooden, metal or electronic.

The bed cradle support & take off the weight of top bedding.

These are semicircular in shape.

Purposes:-

To prevent the top cloth if coming in contact with the patient especially burn patient.

To apply heat in case of drying plaster casts.

Electronic bed cradles are used to supply the desired warm in case of shock.

BED BLOCKS

These are made-up of wood. It may be high or low. These are placed under the foot of the bed for
various reasons. Purposes:-

To prevent shock.

To arrest hemorrhage.

To retain enema

After spinal anesthesia

After tonsillectomy

To provide traction.

To position in postural drainage.

AIR CUSHION

They are round in shape & made of rubber.

These can be inflated with air.

These are used to take off the Weight of body.

Air cushion should not be applied directly in contact with skin.

They should have cover.

Purposes:-

To relive pressure on certain parts of body.

To promote comfort of client.

CARDIAC TABLE /ORTHOPNEIC/ BED TABLE

Usually for pts who are propped up in a sitting position for change of position. • Bed table plcaed in
front with a pillow on it, patient can lean forward & take rest • Table without pillow is used for
writing & meals. • Used for pts with cardiac conditions & asthma. • Makes it possible to use
accessory muscles of respiration. • Position should be changed to relieve fatigue & prevent
embolism.

FRACTURE BOARD

Is a support that is placed under patients mattress to give added rigidity to the mattress.

Usually made of wood/canvas & is constructed to fit the standard hospital bed.

SIDE RAILS

Are bars positioned along the sides of the length of the bed.

Ensure patient’s safety & are useful for increasing mobility.

Provide assistance in rolling from side to side or sitting up in bed.

WEDGE /ABDUCTOR PILLOW

Is a triangular shaped pillow made of heavy foam. • Used to maintain legs in abduction following
total hip replacement surgery.

COMFORT POSITIONS

DEFINITION OF COMFORT POSITION

Fowler’s
Fowler’s position, is a bed position wherein the head and trunk are raised 40 to 90 degrees.

Fowler’s position is used for people who have difficulty breathing because in this position, gravity
pulls the diaphragm downward allowing greater chest and lung expansion.

In low Fowler’s or semi-Fowler’s position, the head and trunk are raised to 15 to 45 degrees; in high
Fowler’s, the head and trunk are raised 90 degrees.

This position is useful for patients who have cardiac, respiratory, or neurological problems and is
often optimal for patients who have nasogastric tube in place.

Using a footboard is recommended to keep the patient’s feet in proper alignment and to help
prevent foot drop.

orthopneic or Tripod

Orthopneic or tripod position places the patients in a sitting position or on the side of the bed with
an overbed table in front to lean on and several pillows on the table to rest on.

Patients who are having difficulty breathing are often placed in this position since it allows maximum
expansion of the chest

Dorsal Recumbent Position

In dorsal recumbent position or back-lying position, the client’s head and shoulders are slightly
elevated on a small pillow.

This position provides comfort and facilitates healing following certain surgeries and anesthetics.
Prone
In prone position, the patient lies on the abdomen with head turned to one side; the hips are not
flexed.

This is the only bed position that allows full extension of the hip and knee joints.

Prone position also promotes drainage from the mouth and useful for clients who are unconscious
or those recover from surgery of the mouth or throat.

Prone position should only be used when the client’s back is correctly aligned, and only for people
with no evidence of spinal abnormalities.

To support a patient lying in prone, place a pillow under the head and a small pillow or a towel roll
under the abdomen.

Lateral position
In lateral or side-lying position, the patient lies on one side of the body with the top leg in front of
the bottom leg and the hip and knee flexed.

Flexing the top hip and knee and placing this leg in front of the body creates a wider, triangular base
of support and achieves greater stability.

The greater the flexion of the top hip and knee, the greater the stability and balance in this position.
This flexion reduces lordosis and promotes good back alignment.

Lateral position helps relieve pressure on the sacrum and heels in people who sit for much of the day
or confined to bed rest in Fowler’s or dorsal recumbent.

In this position, most of the body weight is distributed to the lateral aspect of the lower scapula, the
lateral aspect of the ilium, and the greater trochanter of the femur.

Sims’ Position
Sims’ is a semi-prone position where the patient assumes a posture halfway between the lateral and
prone positions. The lower arm is positioned behind the client, and the upper arm is flexed at the
shoulder and the elbow. Both legs are flexed in front of the client. The upper leg is more acutely
flexed at both the hip and the knee, than is the lower one.

Sims’ may be used for unconscious clients because it facilitates drainage from the mouth and
prevents aspiration of fluids.

It is also used for paralyzed clients because it reduces pressure over the sacrum and greater
trochanter of the hip.

It is often used for clients receiving enemas and occasionally for clients undergoing examinations or
treatments of the perineal area.

Pregnant women may find the Sims position comfortable for sleeping.
Support proper body alignment in Sims’s position by placing a pillow underneath the patient’s head
and under the upper arm to prevent internal rotation. Place another pillow between legs.

Trendelenburg’s
Trendelenburg’s position involves lowering the head of the bed and raising the foot of the bed of the
patient.

Patient’s who have hypotension can benefit from this position because it promotes venous return.

Reverse Trendelenburg

Reverse Trendelenburg is the opposite of Trendelenburg’s position.

Here the HOB is elevated with the foot of bed down.

This is often a position of choice for patients with gastrointestinal problems as it can help minimize
esophageal reflux.

BIBLIOGRAPHY

NET REFRANCE

1)https://www.slideshare.net/NaveenSharma45/comfort-devices?qid=99c7e0f5-9f60-4b78-b40a-

71d5262a320b&v=&b=&from_search=1

2)https://opentextbc.ca/clinicalskills/chapter/3-4-positioning-a-patient-in-bed/

3)https://www.slideserve.com/kass/positions-used-in-nursing-patients-clients